[Squatting cast for biomechanical treatment of decentred hip joints]. / Sitz-Hock-Gips zur biomechanischen Behandlung dezentrierter Hüftgelenke.

The so-called "congenital" luxation of the hip joint is endemic in Central Europe and occurs in about 1% of all newborn infants. By the means of ultrasonographic diagnosis according to the Graf method an early detection instantly after birth has become a good clinical routine in the German-speaking countries. Sonography-based conservative treatment has become the gold standard. The cast in squatting ("human") position is a standard procedure in order to retain the originally decentred or unstable hip joints in the reduced position: 100° flexion and 50° abduction are necessary to fix the hip joint in the reduced position without the risk of avascular necrosis. After the fixation in a squatting-cast, a period of functional bracing in flexed position enhances bony maturation. This two-phase functional conservative treatment can avoid later osteotomies or even early total hip replacement.

[Therapy relevant imaging in modern surgical treatment of arthrosis of the shoulder: interesting facts for orthopedic surgeons]. / Therapierelevante Bildgebung in der modernen Arthrosebehandlung am Beispiel des Schultergelenks: Wissenswertes für den Orthopäden.

CLINICAL/METHODICAL ISSUE: Imaging for shoulder surgery varies a lot nowadays. Advantages and disadvantages of possible imaging methods according to the pathology and treatment options are described. STANDARD RADIOLOGICAL METHODS: Digital projection radiography in 3 planes, ultrasonography, MRI, CT scanning and scintigrams. METHODICAL INNOVATIONS: Special axial view to visualize the glenoid situation, as well as 3-D CT scanning for larger defects and classification. PERFORMANCE: Imaging of the glenoid situation, the version and erosion in axial view x-ray is mandatory to plan and control glenoid replacement. ACHIEVEMENTS: Useful application of imaging methods for the daily routine of orthopedic surgeons. PRACTICAL RECOMMENDATIONS: Digital 3 plane x-ray imaging in arthroplasty surgery is the minimum requirement. For rotator cuff lesions ultrasonography is good. In order to gain information on fatty infiltration of rotator muscles MRI is needed as well as for intra-articular lesions. For bony defects CT and reconstruction 3-D are recommended.

[Ultrasound examination of the shoulder joint]. / Die sonographische Untersuchung des Schultergelenkes.

The ultrasound examination of the shoulder is an effective, quick and painless diagnostic method. The skilled examiner has no problem to detect rotator cuff tears, bursitis, tendinitis and instabilities as well as arthrosis or hematoma of the acromioclavicular joint and biceps tendon rupture. In the literature the sensitivity of ultrasound examination of the shoulder depended from 91 to 100% and specificity from 83 to 100%. The dynamic examination gives a special view of gliding tendons, muscles and bony landmarks of the shoulder. With standardized pictures the orthopedic surgeon should be able to diagnose and document almost every shoulder soft tissue pathology.